Tekrarlayan Kök Kanal Tedavilerinde Antimikrobiyal Yaklaşım

Yazarlar

Özet

Daha önce endodontik tedavi görmüş dişlerde yeniden hastalık oluşması önceki tedavinin başarısızlığına işaret eder. Bu başarısızlık durumunda, doğru teşhis etmek şartıyla akla ilk gelen tedavi seçeneği tekrarlayan kök kanal tedavisidir. Tekrarlayan endodontik tedavi, primer endodontik tedaviye göre farklı mikroorganizmalar içermesinden dolayı daha ileri tedavi seçeneklerine ihtiyaç duyar. Tedavi seçenekleri özellikle bu kanallardan en sık izole edilen tür olan Enterococcus faecalis gibi dirençli mikroorganizmaları yok etmeye yönelik olmalıdır. Özellikle bakteriler için sığınak olan kök kanallarının farklı ve karmaşık anatomisi; ileri görüntüleme teknikleri ve büyütme yöntemlerinin kullanılması ile daha iyi teşhis edilebilmekte ve zorlukların aşılmasına yardımcı olabilmektedir. İzolasyon yöntemleri, güncel ve kabul edilmiş mekanik enstrümanların kullanılması, kanal içi dezenfeksiyon yöntemleri ve bunlara yardımcı olan ilaç aktifleştirme yöntemlerindeki gelişmeler tekrarlayan tedavi başarısını arttırmaktadır. Ayrıca teknolojinin ilerlemesiyle küçülen nano boyuttaki ilaçlar üzerinde yapılan araştırmalar, akıllı mikrorobotlar gibi ileri teknoloji üzerine yapılan araştırmalar özellikle tekrarlayan endodontik tedavilerde başarı oranlarını arttıracağına dair umut vadedici gelişmeler arasında yer almaktadır.

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